Q10: Grace Steyn

I am a social worker with Fraser Health at Royal Columbian Hospital (RCH). My job is to help patients in the hospital who may need access to or support with supportive counselling, crisis intervention, and resources related to critical illness, change in function, or loss of function. The patient and their family are always at the centre and guide my work.

What’s your educational background?

I graduated in 2006 with a Bachelor of Arts degree in Geography and Community Planning from University of the Fraser Valley. After graduation, I worked as a researcher for a federally-funded community development project, and then for a social planning department of a municipal government.

I always knew I wanted to go back to school. Both my parents have graduate degrees and lifelong learning is a family tradition. Even though I really enjoyed the research, policy, and community development work, I wanted to develop my clinical work skills. Also, my dad was a social worker and I was always fascinated by how varied and interesting his job was.

In 2009, I started my Masters in Social Work at the University of British Columbia and my second practicum placement was at Surrey Memorial Hospital. It was there I developed a love for social work in a healthcare setting.

Tell me about a typical day.

My day starts with a mad rush to get myself and my two young children up and ready, drop them off at their childcare centre, and make it into work on time. Along the way I usually enjoy my vital cup of tea!

The first thing I do once I get to work is check my voicemail. I often have messages from the Emergency Department or Intensive Care Unit social worker about patients that arrived overnight and may need support and follow-up in the morning.

Next, I check our computer system for new social work referrals for my units. After I have my referrals, I attend morning rounds with the team on the main Cardiac Surgery unit where I work, and I check in with patient care coordinators on the other units that I cover. Once I have a good idea of the patients I have to see, I prioritize my day based on the most urgent needs.

The rest of the day consists of meeting with patients one-on-one, meeting with family members, liaising with the interdisciplinary team (physicians, nurses, occupational therapist, physiotherapists, home health liaisons), and coordinating and facilitating family meetings with the team, patients, and their families. I spend quite a bit of time on the phone with community partners (Fraser Health’s Mental Health Office, social service agencies, and income-assistance programs) to connect patients with appropriate resources.

My days are extremely varied. Some days, I may be assisting a patient to set up their Advance Care Plan for when or if they are no longer able to make their own care decisions, or I may be supporting a family that has decided to withdraw life support from their critically-ill loved one. Other days, I may be helping a very isolated older adult with multiple complex health issues connect to community resources, or I could be assisting a younger patient apply for income assistance programs. I often counsel and provide resources to patients who are struggling with domestic abuse situations, substance use, and/or homelessness. I may also assist families who live outside of the Lower Mainland, BC, or even Canada to navigate our healthcare system.

Do you have a hard time “shutting work off” before you head home? Does it change the way you interact with anyone?

I am fortunate to both live and work in New Westminster. The downside to this is that my short commute does not allow for much time to switch gears between work and home. I will often go from a tragic and emotionally charged situation, to picking up my young children a few minutes later. It is definitely hard to make that sudden switch, but the embrace of little arms changes my focus really quickly as they need my full attention! Once my children are in bed, I will sometimes reflect on my day and often use a variety of self-care tools to wind down, like stretching, colouring, or mindfulness meditation. Most days, those tools are successful, but some days the intensity and sadness stays with me.

Are there any partnerships with various groups (mental health, homelessness action coalition, etc) that help you do your job?

Social workers at RCH work closely with a variety of federal, provincial, regional, and local agencies and stakeholders. We work closely with the community Mental Health and Substance Use services and the New Westminster Home Health office. Locally, we often refer to and liaise with New Westminster Police Department Victim Services and Domestic Violence and Elder Abuse teams, various community organizations including Century House, Seniors Services Society, Fraserside Community Services Society, Purpose Society, Lookout Society and The Salvation Army.

What is the hardest part of your work?

The hardest part of my job is balancing and prioritizing often competing demands. Making sure I see patients in a timely manner before they are ready for discharge while attending to ongoing crisis situations is a constant challenge.

I spend a lot of time and energy connecting patients with resources and helping them navigate the social assistance network. Whether it is trying to connect a patient with mobility issues with appropriate transportation for ongoing IV therapy, or connecting a patient who is now unable to work due to a serious illness with an income assistance program, it can be frustrating as resources are limited.

The other hard, and inherent, part of my job, is the profound and often raw sadness I encounter. It can be a husband or wife losing their beloved spouse of 50 years, a young patient being diagnosed with an irreversible and debilitating chronic condition, or a patient disclosing a painful history of trauma and self-harm. As a social worker, I am trusted with extremely personal details of my patients’ lives, and it’s hard not to embrace and share in their pain and sadness.

What’s the best part of your work?

The best part of my job is knowing I’ve helped a patient, either emotionally or physically. My help may have lessened their stress levels, made their discharge home easier, or connected them with appropriate resources that will support their ongoing well-being. Some of my best moments have happened when a conversation with a patient or family member ends and it is clear that they feel heard, their feelings have been validated, and there is a sense of calm, hope, and understanding.

Do you have any favourite memories?

Some my fondest memories are where I have worked closely with a patient and/or their family and there was a real sense of collaboration and trust between myself and them.

I have worked with families during very critical and stressful times where there was much uncertainty about whether their loved one would survive and what level of physical and cognitive function they would return to. Over several days and weeks, I provided supportive counselling to both the patients and their family members, discussing their fears, concerns, hopes, and wishes. Through these conversations, I was able to communicate their concerns to the interdisciplinary healthcare team and work together to develop a solid hospital care plan and an eventual discharge plan. These situations resulted in a really positive experience for both the patients and their families, even though they started with much uncertainty and crisis.

What are the advantages of RCH having a social worker on staff?

Royal Columbian Hospital has a highly trained and skilled team of social workers who specialize in the psycho-emotional and social needs of patients and their families. A visit or admission to hospital as a result of a sudden or chronic illness or accident can impact, and disrupt a person not only physically, but emotionally, socially, and functionally. It also will likely affect their family, especially those the patient may be caring for such as children, a spouse, or parents. The patient and their family may be struggling with uncertainty, grief, and fear. They may be unable to work during, and even after, their admission creating financial uncertainty and distress.

Social workers receive training that provides us with a unique lens and skill set to assess these challenges and needs, to provide appropriate support (including therapeutic counselling and financial, legal, practical supports), and to advocate for our patients using a systems perspective. Social workers can address a variety of complex psychosocial issues including completing safety and risk assessments, supporting patients and their families in crisis and stressful situations, and assisting with complex healthcare system navigation.

Has doing this work changed you as a person?

It has definitely changed how I look at life and my relationships. My work has taught me that life is extremely fragile and that a healthcare crisis or even tragedy can happen to anyone at any time. This has made me really cherish my own health and the health of those I love.

My work has also demonstrated to me that people can be extremely resilient and, in spite of extreme adversity, can manage to function and live very full lives with the right support and resources. Focusing on strengths and instilling hope for the future has influenced not only my social work practice, but I also how I relate to others in my personal life.